THE USE OF LDN [LOW DOSE NALTREXONE] FOR PTSD DISSOCIATIVE SYMPTOMS
A COUPLE YEARS AGO I SAW A RESEARCH REPORT INDICATING THAT LOW DOSE NALTREXONE CAN REDUCE OR EVEN STOP DISSOCIATIVE REACTIONS THAT OCCUR WHEN AN EVENT HAPPENS OR A MEMORY IS TRIGGERED THAT RECALLS PAST TRAUMATIC EXPERIENCES WHERE THE PERSON HAS LEARNED TO COPE BY DISSOCIATING [IN ONE FORM OR ANOTHER IT IS LIKE REMOVING ONESELF FROM AN EXPERIENCE TO PROTECT ONESELF FROM BEING OVERWHELMED BY ANXIETY AND FEAR]. THIS EFFECT OF LDN WAS NOTICED IN PEOPLE WITH CHRONIC PAIN WHO WERE PRESCRIBED LDN TO SEE IF IT COULD REDUCE THEIR PAIN AND WHO WERE ALSO COPING BY DISSOCIATING. IN THIS INITIAL EXPERIENCE WITH LDN THE AVERAGE COMPOUNDED DOSE WAS 4.6 MG PER DAY. THE REDUCTION IN DISSOCIATIVE SYMPTOMS WAS WITHIN A COUPLE OF DAYS. IT IS NOT KNOWN WHY THIS REDUCTION IN THESE SYMPTOMS OCCURS.
POSITIVE RESPONSE TO LDN WAS DESCRIBED BY PAPE AND WOLLER [Nervenarzt 2015Mar;86(3):346-51] REPORT ON THE EXPERIENCE OF 15 PEOPLE WITH SEVERE TRAUMA RELATED DISSOCIATIVE DISORDERS WHO WERE TREATED WITH 2-6 MG/DAY OF NALTREXONE AND 11 OF 15 REPORTED IMMEDIATE BENEFIT AND 7 REPORTED A LASTING BENEFIT. THE IMPROVEMENT WAS DESCRIBED AS PERCEPTION OF THEIR SURROUNDINGS AND THEIR INNER LIFE IMPROVED. ALSO, ASSESSMENT OF REALITY AND DEALING WITH THIS REALITY IMPROVED AND THEIR ASSESSMENT OF THEIR OWN BODIES AND AFFECTS [FEELINGS] AND SELF REGULATION.
THERE HAVE BEEN SPECULATION THAT DISSOCIATION MAY BE RELATED TO DYSREGULATION OF THE ENDOGENOUS OPIOID SYSTEM AND CONTRIBUTED TO LDN BEING USED WITH DISSOCIATIVE DISORDERS.
THERE IS SOME EVIDENCE THAT SOME DISSOCIATIVE SYMPTOMS RESPOND TO LOW DOSES OF NALTREXONE [ < 10 MG] AND OTHER SYMPTOMS RESPOND TO HIGHER DOSES OF NALTREXONE [ > 25 MG]
IT HAS BEEN MY EXPERIENCE THAT IT IS HARD TO DEFINE WHAT ARE DISSOCIATIVE SYMPTOMS EVEN THOUGH CATEGORIES OF SYMPTOMS HAVE BEEN DEFINED INCLUDING: ZONING OUT; BEING DETACHED FROM ONE SELF [CALLED DEPERSONALIZATION]; THE WORLD SEEMS DREAM LIKE [DEREALIZATON]; THERE ARE GAPS IN MEMORY [AMNESIC SYMPTOMS]; AND FEELING THAT OUR IDENTITY CHANGES [LIKE NOT BEING ONE SELF OR A BLURRED SENSE OF SELF].
SINCE THESE DISSOCIATIVE REACTIONS ARE VERY RAPID AND AUTOMATIC RESPONSES, IT IS NOT CLEAR AT TIMES IF SOME RESPONSES ARE DISSOCIATIVE. EXAMPLES I HAVE SEEN WITH MY PATIENTS INCLUDE: SUDDEN ALCOHOL INTAKE, SLEEPING MORE, SUDDEN SLEEPLESSNESS, SUDDEN FATIGUE, GENERALIZED LOW ENERGY, AUDITORY HALLUCINATIONS, AND POSSIBLY CONSPIRACY FEELINGS.
IT IS EXCITING FOR ME TO RECOGNIZE THAT SOME OF THESE BEHAVIORS MAY ACTUALLY BE DISSOCIATIVE COPING AND THEREFORE THESE MAY BE TREATED SUCCESSFULLY BY NALTREXONE AND THEY MIGHT NOT OTHERWISE BE SUCCESSFULLY TREATED.
